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  • Title: "Downgrading" of gastric varices with multiple collateral veins in balloon-occluded retrograde transvenous obliteration.
    Author: Fukuda T, Hirota S, Sugimoto K, Matsumoto S, Zamora CA, Sugimura K.
    Journal: J Vasc Interv Radiol; 2005 Oct; 16(10):1379-83. PubMed ID: 16221910.
    Abstract:
    The efficacy of a "downgrading" method for treatment of gastric varices (GVs) was evaluated in 15 patients who had undergone balloon-occluded retrograde transvenous obliteration (B-RTO) of GVs with multiple collateral veins. Downgrading in this study was meant to transform high-grade GVs into GVs with a low-grade architecture more amenable to treatment. Success was defined as gastrorenal shunt occlusion at the proximal site with a 6-F balloon catheter advanced over a microcatheter and without opacification of large collateral vessels. Thirteen of 15 patients with grade 3/4 GVs had their GVs successfully downgraded. The procedure is thought to be safe and effective in the initial B-RTO procedure.
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